Integrating GDM management in primary care: Gulf Cooperation Council (GCC) perspective.

Diabetes is prevailing universally and Gulf Cooperation Council (GCC) is no exception. Pregnancies associated with gestational diabetes place women at high risk of natal complications. Statistics from GCC gives variable figures for GDM. Family Physicians are the first level health care providers and their role in management of GDM can be promising. This has been evident from a focused group study where patients prefer screening for GDM in primary care settings. Strengthening of primary care is important universally. Government should have mandatory primary care registration to be referred to secondary level for obstetric follow up and management. An important issue needing attention is presence of multiple criteria for diagnosing and screening GDM. There is need for a single guideline globally to avoid confusion for primary care providers.10 Primary care centers can better be utilized to screen for GDM at early stages. This will decrease the load on secondary and tertiary care centers and can also maintain continuity of care.

Frequency and risk factors for intestinal parasitic infection in children under five years age at a tertiary care hospital in Karachi.

OBJECTIVE: To assess the frequency and risk factors for intestinal parasitic infection in children under five years age at a tertiary care hospital, Karachi. METHODS: A cross sectional survey of 269 children under five years was conducted at a tertiary care hospital on a pretested self-administered questionnaire. Stool smears were examined under light microscope with direct saline smear and lugol's iodine solution. Parasitic detection was confirmed by formalin ethyl acetate concentration method. RESULTS: Stool test positive for parasites was found in 185 (68.8%) children. Majority of children 144 (53.5%) were among 4-5 years of age. Less than one third (20.4%) showed moderate malnutrition (p = 0.05) while 44.6% were found to have mild anaemia (p < 0.001). Giardia lamblia was the most common parasite (25.3%) identified. Only 40% of children were found to wash hands with soap after using the toilet (p < 0.001). Eating mud/pica was present in 36% children (p < 0.001). Less than half (48%) of the mothers said that they do not purify drinking water (p < 0.001). CONCLUSION: The frequency of intestinal parasitic infection was found to be high among children under five years. Major contributory factors were lack of hand washing and drinking unpurified water along with habit of eating mud/pica. This study identifies at-risk population of less than five years of age who could benefit from health education of parents.

Knowledge of medical students regarding diabetes mellitus at Ziauddin University, Karachi.

OBJECTIVE: To assess knowledge among medical students of Ziauddin University regarding Diabetes Mellitus. METHODS: A cross sectional survey of medical students from first year to final year at the medical college was conducted on a pretested self-administered questionnaire. Students were divided into preclinical and clinical years for analysis. RESULTS: A total of 366 students participated, with 145 (39.6%) from the preclinical group and 221 (60.4%) from the clinical group. Overall 89% students knew that diabetes is a metabolic disorder, 78% knew that pancreas is the site of insulin production and 77% students correctly identified main target organ of insulin. Regarding presentation, 67% said polyphagia, 50% said weight loss while only 18% claimed pruritus vulvae to be the presenting symptom. Majority from the clinical group (95%) while 86% of preclinical group knew about risk factors for diabetes (p = 0.003). Regarding prevention, 89% of clinical group knew that diabetes is preventable but 49% preclinical students did not have an idea of prevention (p < 0.001). A large number from clinical group (87%) said that there is some criteria of screening for diabetes while only 30% of preclinical group knew about screening (p < 0.001). Correct diagnostic criteria for diabetes according to WHO was identified by 55% clinical and only 6% of preclinical students (p < 0.001). Over two-third (78%) of clinical while only 50% of preclinical students said that diabetes should not always be treated with drugs (p < 0.001). CONCLUSION: The knowledge of students about diabetes was more in the clinical group as compared to the preclinical group, whereas, overall knowledge of the students was adequate. Medical students are the future physicians, therefore the medical curriculum should lay emphasis on educating students, patient based clinically oriented approaches for dealing with this epidemiologically important disease.